Abstract Neuropathic pain (NP) is a debilitating symptom experienced by a number of patients with cancer. We evaluated the validity of ID Pain as a screening tool for NP in breast cancer survivors ...using the Self-Report Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) and a reported diagnosis of NP as criterion measures. Two hundred forty breast cancer survivors with a mean age of 58 years (standard deviation = 16) participated in this survey. Forty-five percent of the sample reported having pain in the past week. Of those reporting pain, 33% reported that they had been diagnosed by their health care provider with NP, 39% had a positive ID Pain (≥2) score, and 19% had a positive S-LANSS score. The most commonly endorsed ID Pain item was “hot/burning” ( n = 48) followed by feeling “numb” ( n = 47) and “pins and needles” ( n = 45). Total ID Pain score was significantly associated with a clinical diagnosis of NP ( r = 0.41; P < 0.001) and the S-LANSS total score ( r = 0.54; P < 0.001). Receiver operating curve analysis demonstrated that ID Pain has a predictive validity of 0.72 and 0.70 for diagnosis of NP as made by clinicians and the S-LANSS, respectively. We also found that an ID Pain score greater than or equal to 2 corresponded with the likelihood of NP in this sample, consistent with the original ID Pain development study. This study provides evidence for ID Pain as a valid screening measure for NP in breast cancer survivors.
The purpose of this study was to prospectively compare CT angiography with conventional angiography for detecting stenosis at the carotid bifurcation.
Thirty-five patients referred for evaluation of ...carotid artery disease were studied with conventional angiography followed by CT angiography 4-24 hr later. Seventy carotid arteries were studied. CT angiograms were acquired by using 40-sec spiral scans with a 2-mm/sec table speed, 2-mm beam collimation, and IV iodinated contrast material injected at 2.5 ml/sec. Studies were interpreted on the CT workstation by using three-dimensional shaded surface objects and multiplanar reformations requiring 10-15 min per artery. The conventional and CT angiograms were interpreted by separate observers who did not know the results of the other imaging study. The degree of stenosis was determined by using the guidelines of the North American Symptomatic Carotid Endarterectomy Trial collaborators. Each artery was categorized as normal, mildly stenosed (1-29%), moderately stenosed (30-69%), severely stenosed (70-99%), or occluded.
The degree of carotid artery stenosis on the CT angiograms correlated well with that seen on the conventional angiograms (r = .928, p < .001). With CT angiography, all occluded internal carotid arteries were correctly identified, and no arteries were wrongly classified as occluded. The degree of stenosis was overestimated on CT angiograms by greater than 10% in 16 arteries, especially when calcified atherosclerotic plaque was present. In some of these cases, the severity of the stenosis was underestimated on the conventional angiograms. All arteries, except one, with severe disease seen on conventional angiograms were correctly classified on the basis of the results of CT angiography.
Results of CT angiography had a high degree of correlation with results of conventional angiography in the evaluation of carotid artery stenosis. CT angiography is multiplanar and allows differentiation of calcified plaque from contrast material, which provides information about plaque calcification, ulceration, and size that cannot be obtained with conventional angiography.
The ageing of Jason-1, the risk of losing control of the satellite, and the collision risk with TOPEX/Poseidon (still in orbit and no longer maneuverable) initiated a reflection on a so-called ..."extension of life phase" (EoL) phase that would involve moving Jason-1 to a new orbit to mitigate collision risks while optimizing its science return. This paper describes three practical consequences of any such EoL phase: 1) the ability to build an unprecedented low inclination and high precision geodetic dataset, 2) the loss of coordination with Jason-2 and the associated mesoscale (and sea state) sampling degradation, and 3) the increased topography height error budget stemming from the use of a gridded mean sea surface in place of the classical repeat track analysis that operational systems have been using and improving for almost two decades.
More than 17,000 potential orbits were analyzed to identify desirable altitude ranges that could host a Jason-1 EoL phase. The objective was to minimize the sampling degradation of ocean observations (primary objective of Jason-1) while securing a good geodetic EoL dataset (secondary objective of Jason-1). After a first automated screening and scoring process, the final orbit candidates are analyzed through an end-to-end Observing System Simulation Experiment (OSSE) protocol, assessing the multimission observational capability of the EoL phase in a DUACS/AVISO-like system.
All EoL orbits are shown to be largely inferior to the interleaved orbit as far as oceanography is concerned. Yet some EoL options are shown to be more desirable than others because their sampling patterns blend well with Jason-2. Good geodetic orbit options could provide a unique bathymetry-oriented dataset and help improve gridded mean sea surfaces (MSS), while repetitive options with a short cycle could cancel some additional EoL errors if a conservative repeat track strategy is preferred.
Abstract
Introduction
Prior to sleep, animals perform various sleep-preparatory behaviors, yet little is known about their contribution to sleep physiology. Sleep hygiene, which involves proper sleep ...preparation, is an effective treatment for insomnia in humans. The high prevalence of sleep disorders and drawbacks of available pharmacological interventions necessitate a better understanding of the ecological and evolutionary contexts of sleep. Nest-building is a sleep-preparatory behavior performed by many species. In this study, we aimed to determine whether the presence of a nest modulates sleep. Specifically, we investigated the effects of a nest on sleep/wake architecture and activity in wake-promoting neurons in mice.
Methods
To examine the role of nesting in sleep/wake architecture, we recorded EEG/EMG activity over 24 hrs (n=14, 7 males and 7 females) in the presence/absence of a nest. To determine whether the lack of a nest activates wake-promoting neurons, we utilized TRAP (targeted recombination in active populations) technology to label neurons activated by nest removal (n=4 mice per experimental group).
Results
Mice without nests exhibited increased latencies to NREM and REM sleep and spent less time asleep during the inactive/light phase. Mice without nests also exhibited shorter episodes of NREM and REM sleep and more transitions between arousal states. Additionally, our preliminary results suggest that nest removal significantly increases population activity in multiple brain regions, including several cortical and thalamic regions.
Conclusion
Our findings support the hypothesis that the presence of a nest facilitates and consolidates sleep. The causal role of specific neuronal populations in sleep fragmentation in the absence of a nest remains to be elucidated. Taken together, our findings provide the first evidence for a role of sleep-preparatory behaviors in the facilitation and consolidation of sleep and could shape the development of novel treatments for sleep disorders.
Support
This work is supported by the Sloan Alfred P. Foundation, the Brain and Behavior Research Foundation, and the Eisenberg Translational Research Award.
Background Using a transcriptional profiling approach, we recently identified myeloid-related protein 8/14 (MRP-8/14) to be expressed by platelets during acute myocardial infarction (MI). Elevated ...concentrations of MRP-8/14 are associated with a higher risk for future cardiovascular events in apparently healthy individuals but have not been assessed with respect to prognosis in patients with acute coronary syndrome. Methods We performed a nested case-control study (n = 237 case-control pairs) among patients enrolled in the Pravastatin or Atorvastatin Evaluation and Infection Theraphy: Thrombolysis in Myocardial Infarction 22 (PROVE IT-TIMI 22) trial (mean follow-up 24 months) to investigate the risk of cardiovascular death or MI associated with MRP-8/14 measured at 30 days after an acute coronary syndrome. Results Patients with cardiovascular death or MI after 30 days (cases) had higher median 25th, 75th percentile MRP-8/14 levels than patients who remained free of recurrent events (5.6 2.8, 13.5 mg/L vs 4.0 1.9, 10.1 mg/L, P = .020). The risk of a recurrent cardiovascular event increased with each increasing quartile of MRP-8/14 ( P -trend = 0.007) such that patients with the highest levels had a 2.0-fold increased odds (95% CI 1.1-3.6, P = .029) of a recurrent event after adjusting for standard risk indicators, randomized treatment, and C-reactive protein. Patients with elevated levels of MRP-8/14 and high-sensitivity C-reactive protein showed significantly increased risk of cardiovascular death or MI compared with patients with the lowest levels of both markers (adjusted odds ratio 2.1, 95% CI 1.2-3.8). Conclusions Myeloid-related protein 8/14 may be a useful biomarker of platelet and inflammatory disease activity in atherothrombosis and may serve as a novel target for therapeutic intervention.
Peptide mediators, including tumor necrosis factor‐α, interleukin 1 and interleukin‐6, are associated with many chronic inflammatory diseases and septic shock. As such, considerable information has ...been collected by means of study of cytokine secretion from isolated cells or plasma cytokines during septic shock or inflammatory disorders. In this investigation, we used semiquantitative polymerase chain reaction analysis and a recently developed liver slice model to examine the characteristics of cytokine profiles that occur in the liver, the main organ involved in endotoxemia, after lipopolysaccharide challenge. Tumor necrosis factor‐α, interleukin‐1α and interleukin‐6 were rapidly secreted after in vivo LPS exposure or when added in vitro to rodent or human liver slice samples. This increase was associated with increased cytokine‐specific mRNA transcripts. Kinetic analysis revealed that most tumor necrosis factor‐α is released from the liver within 1 hr of lipopolysaccharide challenge, whereas interleukin‐1α and interleukin‐6 continued to be produced for the entire culture period. Addition of monoclonal antibodies against tumor necrosis factor‐α or interleukin‐1α to the culture partly inhibited interleukin‐6 secretion, indicating that interleukin‐1α and tumor necrosis factor‐α help mediate and sustain interleukin‐6 synthesis. Depletion of hepatic sinusoidal macrophages (Kupffer cells) by a liposome‐mediated macrophage “suicide” technique indicated that almost all of the secreted interleukin‐1α and tumor necrosis factor‐α originate from these cells, whereas interleukin‐6 secretion might also include other cell types. This study supports and extends previous findings and allows for a more rational approach to developing effective therapies against chronic inflammatory diseases and septic shock. (Hepatology 1994;19:480–488).
Problem: A homogeneous perception of safety is important for the achievement of a strong safety culture; however, employees may differ in their safety perceptions, depending on their position and/or ...hierarchical level within the organization. Moreover, there is limited information on the antecedents of safety culture. This study examines how safety training, driver scheduling autonomy, opportunity for safety input, and management commitment to safety influence individuals' perceptions of safety culture.
Method: Data for this study were drawn from 116 trucking firms, stratified by three safety performance levels. The data were collected from drivers (lowest hierarchical level), dispatchers (medium hierarchical level), and safety directors (highest hierarchical level), regarding their perceptions of their respective corporate safety cultures. Perceptions of safety culture were analyzed through a linear regression using dummy variables to differentiate among the three hierarchical groups. The resulting model allowed for examination of the specific antecedents of safety culture for the three employee groups and the extent to which the hierarchical groups were in agreement with each other.
Results: Driver fatigue training, driver opportunity for safety input, and top management commitment to safety were perceived to be integral determinants of safety culture in all three groups.
Impact on industry: Trucking firms seeking to strengthen employees' perceptions of safety culture might begin by improving these safety management practices while appreciating that they may have a different impact depending on the employee's hierarchical position (e.g., drivers' perceptions of safety culture are more influenced by top management commitment and driver fatigue training). A fourth safety practice examined, driver scheduling autonomy, was not found to be instrumental in shaping safety culture for any of the three hierarchical levels. Consistent with previous research, implementation of stronger safety cultures should result in fewer accidents.
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